Tympanic Membrane Temperatures Compared to Rectal and Oral Temperatures

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Abstract
One hundred thirty-seven children at the Cleveland Clinic Foundation were enrolled in a study comparing the accuracy and acceptability of tympanic membrane temperatures taken with Thermoscan® to rectal or oral temperatures taken by IVAC® electronic thermometers. The mean age of the rectal/ear group was 1.2 ± 0.86 years (range 0.08- 5.0 years) with 22 females and 21 males. The mean age of the oral and ear group was 9.0 ± 4.24 years (range 3 - 18 years) with 44 females and 50 males. Significantly large (p < 0.01) correlation coefficients were present between temperatures in the left ear and right ear (0.92), rectal and mean ear (0.77) and oral and mean ear (0.68). The temperature difference between mean ear and rectal measurements was -1.1° ± 0.51 °C and the temperature difference between the mean ear and oral measurements was -0.20° ± 0.59°C. A relative lack of correlation between ear and oral temperatures was noted with flat tympanograms, otoscopically diagnosed middle ear effusion, and with red-white or red tympanic membranes. However, small subgroup sizes (6-16) may have contributed to this lack of correlation. Parents and physicians were impressed by the 2.5 second speed of the new technique. However, younger children were nearly as likely to resist and cry with ear as with rectal temperatures. Parents were comfortable with the ease, cleanliness and safety of ear temperatures. While these data indicate a strong correspondence of ear temperatures with oral and rectal temperatures, parents were not as confident of ear temperatures' accuracy. Further public education may be necessary to alleviate minor concerns about the accuracy of tympanic membrane temperature measurements.